Provider Demographics
NPI:1639177348
Name:DOUCET, LUCIUS J III (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIUS
Middle Name:J
Last Name:DOUCET
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8490 PICARDY AVE
Mailing Address - Street 2:BLDG 600-B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3731
Mailing Address - Country:US
Mailing Address - Phone:225-810-3911
Mailing Address - Fax:225-810-3954
Practice Address - Street 1:8490 PICARDY AVE
Practice Address - Street 2:BLDG 600-B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3731
Practice Address - Country:US
Practice Address - Phone:225-810-3911
Practice Address - Fax:225-810-3954
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.019318174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5U384Medicare PIN
F81807Medicare UPIN
LA1639177348Medicare NSC
LA1083899173Medicare NSC